I almost never post, as I don't feel as qualified as most posters.  But I absolutely love this comment by Barbara.  It really reflects what I have learned as an educator in the medical field for 20+ years.  Really listening to each mom and helping her achieve her goals with her baby will result in more breastfed babies and more respect for our profession.

Patty Usher



> On Feb 4, 2015, at 7:52 AM, Barbara Robertson <[log in to unmask]> wrote:
> 
> Dear Colleagues,
> I have been enjoying this conversation. In my opinion, poor communication is a huge problem.
> I have been re-reading Motivational Interviewing for the Health Care Professionals and it is astonishing how ineffectively most health care providers communicate. They don't have the skills or the time to do an effective job.
> 
> Our words can hurt. They can insult the person we are talking to (They must think I am stupid that I don't know this!) and make it clear that we are not really listening to or caring about what our clients are really thinking and feeling. By insulting and disregarding our clients agenda (or maybe not even finding out what their issue was in the first place) we are greatly lowering the odds that any positive change will take place. Why would they listen to us?
> 
> What is positive change? Well, there's another opportunity for being at odds with our client's agenda. Her agenda maybe that she needs more sleep. If we disregard this by emphasizing that she needs to feed on demand, babies wake up frequently at night and this behavior is normal, she may feel as if breastfeeding may be impossible for her. She also may feel that you are judging her for being a bad mother for not feeling able to handle the night interruptions.
> 
> Instead of giving her lots of info, you listen to her feelings, reflect them back to her to check for accuracy, find out what she has already tried, and then brainstorm how she might make her nights easier, she is more likely to be receptive to the idea A) that her little baby needs this RIGHT NOW but not for the rest of their lives and she can keep doing it for awhile B) come up with a way to make it easier for her or C) have her partner give a paced bottle or finger feeding of milk during the night so she can have a 4-5 stretch of sleep.
> 
> What? A bottle, sleep through a feed? Yes, if she is going to quit breastfeeding because she feels desperate, one missed feeding at night is better then tossing in the towel all together. In my opinion. Her agenda is crucial. But you will not have any idea at what her agenda is if you don't listen to her carefully. I find that most of my clients do keep going in very hard situations if they feel heard and cared for.
> 
> Good communication also opens the door to variations on exclusive breastfeeding, which is our agenda. Maybe she does partially breastfeed. Maybe she pumps and gives her baby her breastmilk. Not ideal in a perfect world but better than exclusively formula feeding. Most people I work with don't really see a little formula as a health risk. They know "breast is best" but they don't know the risks of formula. They are also already using it. And it has helped. Their fussy baby is calm and sleeping. How can you fight that? You can't fight it. But as you form a relationship you can check in with her goals (she usually wanted to exclusively breastfeed) and weave in info without insulting what they have already done. And with time get rid of the formula if possible.
> 
> I am in private practice so I see mothers who are already in deep trouble when they come to me. They have babies that aren't latching and half a milk supply. This is hard!
> 
> These moms didn't get to this place by themselves. Our culture, their doctors, the birthing process, their peds, friends, families, have set them up for failure for the most part. Lack of accurate medical information and support runs rampant.
> Breast is best. This is so insulting to families. They know that breast is best.
> What are your feelings about how you are going to feed your baby? This question opens up a conversation that provides an opportunity for understanding and information sharing.
> 
> I guess the bottom line is that if we are on our high horses yelling "breast is best" we will have lost a great many families before we have even started. They know I think "breast is best". I am an IBCLC after all.
> 
> -- Barbara Robertson, MA, IBCLC, RLC The Breastfeeding Center of Ann Arbor bfcaa.com
> 
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